What is ADHD and How do You Manage it?

Posted by Dr. Noel Swanson on May 17, 2008
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There are some children who suffer from Attention Deficit Hyperactivity Disorder (ADHD). The symptoms exhibited by these children are:

1) Poor attention span and concentration – unless totally engrossed in something (like a computer game).

2) Poor concentration and memory

3) Impulsivity – doing things without thinking first

4) Easily frustrated – often leading to temper tantrums and outbursts

The above traits are even shown by people who are not suffering from ADHD. Because of ADHD children suffer in various fields and activities in and out of school. They have to face defeat and failure in various areas like:

a) at school (they are not able to pay attention or finish their work in time or they can be disruptive and destructive in class, may be talking excessively in the class )

b) at home (often distracted, therefore not getting chores finished, constantly talking, “hyperactive”, getting into fights with siblings, difficulty getting ready in the mornings and at night, often clumsy), and

c) socially (unable to take turns or wait in line, bossy and overbearing, easily frustrated leading to temper outbursts and aggression, impulsive, so often in trouble for doing antisocial actions e.g. unwise “practical jokes”).

It would not be appropriate to include ADHD as an injuries or a disease as its onset is not dependent on a germ or any specific physical malfunction. This comes into effect only as a result of some part of the brain not working at peak efficiency and not contributing totally.

ADHD can be called a hereditary condition, where parents and children show similar symptoms. The symptoms and the ADHD condition does not go away in short span of time and takes a long time to get under control. Sometimes children suffer from ADHD through their teens into their adulthood also.

HOW IS ADHD MANAGED?

Children suffering from ADHD can get long term complications which may run into their adulthood as well. These complications could be:

a) Their fear of failure at school owing to poor concentration, leading to school drop out

b) Are constantly in trouble because of their impulsive behavior

c) Their fear of taking recourse to anti-depressants such as drinks, drugs, crime etc to avoid getting anxious and depressed.

All of these, in turn, can lead to long term complications that affect functioning in adulthood.

The goal of management is, therefore, to prevent complications. This is a long term process, so the most important people to take charge of this are the parents. It is you as parents who have to live with the child, you who are most concerned about his/her long term well-being, and you who know your child best. If you do not take an active role in managing the difficulties then whatever else other people do will be unlikely to make much difference. However, if you do your part then there is much that others can do to help you along the way. Effective management is likely to include the following components:

COMMITTED PARENTS. These are parents who work wholeheartedly towards the betterment of the child. There is more than adequate information available in the form of books and videos to guide parents on how o assist their ADHD afflicted child. They just need to buy or borrow these read them and be better informed abut this so as to be effective. It is good to discuss what you read with a professional or a local support group as there is a lot of mis-information on this subject. This is especially from self professed guru’s who profess magic-cures for your child.

GOOD COMMUNICATION between home, school and other professionals. This especially applies to home and school, so do all that you can to meet regularly with the school to work together on solutions for your child.

ADJUSTMENTS IN THE ENVIRONMENT. Children with ADHD do best in a quiet, calm, structured, low-stimulation environment (e.g. one to one) and poorly in chaotic situations (e.g. busy classrooms, noisy, busy homes). As a family you may want to find ways to reorganise life so that it is less stressful for all of you. At school the teachers will be doing the same, and it is best if the two can be co-ordinated.

CLEAR BEHAVIORAL MANAGEMENT STRATEGY. These children respond best to very clear expectations of behavior, and very clear rewards and punishments – with rewards being more frequent than punishments. If you are having difficulty in doing this at home you may want to talk about some strategies with your key worker.

PARENTAL SUPPORT. Since getting along wit these children and bringing them up takes a lot of doing , the parents themselves are likely to get depressed and break up. To avoid marriages to break up and to maintain harmony, it is advisable for parents themselves to seek assistance from parent support groups, parent training groups, respite care, marital counseling, family therapy are such support groups and organizations.

MEDICATION. While there is no medicinal cure for this affliction, medicines do help in reducing the symptoms. If these symptoms are reduced, the child gets an opportunity to learn social behavior, academic knowledge and other skills. Medication is not a cure, but can be an invaluable help. To ensure that the right medicine and in the correct dosage is provided, you would need to consult a professional worker.

There are several types of medication that are used. The most common are the “stimulants” (discussed on the next page), but increasingly common is the new medication atomoxetine, which seems to work very well with few side effects. Ask your doctor for full information.

As health professionals we cannot raise your child for you, nor can we solve all your problems as you travel with your child along life’s journey. What we can do, however, is to assist you in getting unstuck when you get stuck along the way. We will try to help you to sort out all of the above points as best you can.

But, in the end, it is you and your family who have to live with it, and so the more you learn about it, and the more you learn the best ways to manage it, the better your chances of a good outcome.

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